Posts Tagged ‘Nutritional gatekeeper’

Just a few days ago I sat down with a patient and then nearly jumped back up again in excitement.

“Ms. J! You’re doing it!”

“I know,” she said with a shy smile.

You have to understand, Ms. J and I have sat down opposite each other for more than a few appointments where nothing has really changed. She usually beats up on herself for it, I usually ask her not to pick on my patient. Then we talk again about motivation, about her pre-diabetes, about her family’s health, the usual.

What I can’t remember ever talking about is success like this! She has steadily dropped a pound a week for the last 3 months (the pace I usually recommend.)

Even better, her blood work has come back to normal just that quickly. Seeing a genuine smile on her face and not hearing a single negative word about herself was great, let me tell you. Seeing a new determination and understanding that she is in control was even better.

Best of all? Knowing the long-term effect her better choices could have on her family.

According to Dr. Brian Wansink, Ms. J is a nutritional gatekeeper. In our culture, Mom is often the one who plans, shops for and prepares meals and snacks. This means that when Mom gets motivated to choose healthy foods and habits, everybody at home finds their eating habits moving the same way. I love it!

Like most men, I love hearing those words. Even if this didn’t come from Dr. Mary, it still felt good. Particularly since I heard it from a very smart nurse who is also the nutritional gatekeeper for the rest of her family.

Kate is always a delight to be around, funny and open. Like many of us, she has also struggled with food and weight for a while now. I know she has lots of ‘book knowledge’ about health and diet and nutrition but our conversations over the past few years have shown me how little of that knowledge she applied to herself.

Today she told me that she had given her best friend and her husband copies of my book but never read it herself until very recently. As expected, she knew everything she read – it isn’t rocket science. The “You were right” part came as she quoted her favorite part of the book. “Every calorie counts – you were right!”

And just like that, she sees her food and choices differently. The weight has started to come off and even better, she knows why it came off and that it can continue. The look in her eyes was pretty awesome, let me tell you. A person that finally feels empowered for her health and wellness and weight gets a look of fierceness about them. After years of struggling and losing, she knows she can win!

She surveyed the battlefield. Weary from day-long work, she knew that this fight was essential. Only she could protect her castle from the horde. Only she could defend her domain from the onslaught.
It was … suppertime.

Kurt Lewin came up with the phrase ‘Nutritional Gatekeeper‘ in 1943. He used the term to describe the person in a household that made the food and mealtime decisions of what to buy, prepare, and eat.
As my (hopefully not too sexist) heroine demonstrates, most of the Nutritional Gatekeepers in our society are women. This is truly a position of power – these people shape our health in very profound ways.

The Gatekeeper decides what is bought, what is cooked, what is eaten, what is saved, and what is thrown away. The health of the whole family hinges on the Gatekeeper’s decisions. As a doctor, even before I knew the term I knew how important this person’s role is.

If the Gatekeeper chooses healthy meals, the whole family is likely to be healthy and lean. If the Gatekeeper does not make healthy choices, often there is someone in the family with health issues related to obesity.
I knew if I could convince the Gatekeeper to change her/his outlook and goals, the whole family could be transformed.

Well child visits are one of the times this comes up in my office. Many scientists have shown that overweight kids are much more likely to become obese adults. In other words, kids who are too high on the growth curve are very likely to end up at an unhealthy weight when they grow up.

Even though it’s hard, I talk to parents about this from the first time it is a problem, sometimes before the child can talk. I remind them of how important fresh veggies and fruits are and I make sure they know how much I hate juice for kids.

Chocolate milk? Stop it. After-school snacks? Choose low-calorie ones like apples. No more bottle in the crib (which also causes ear infections!) No more bottle after 18 months old.

Once the child’s weight and food habits are safe to talk about I approach the topic for the rest of the family. Remember: if the menu changes, everyone wins.